The cure for Ebola may have already have been developed by drugs companies, but ethical dilemmas and financial concerns are holding back hopes of a faster cure, scientists have warned.
The worst ever epidemic of the virus, which has swept West Africa, has killed more than 670 people, sparking fears Ebola could move to the UK.
Two people have now been assessed for the virus in Britain, while two American health workers - a doctor and a missionary - have been hospitalised in Liberia after contracting the disease, prompting missionary groups to evacuate non-essential personnel.
But panic grows. Jeremy Farrar, professor of Tropical medicine at the University of Oxford and director of the Wellcome Trust, claimed the mounting death toll was "unacceptable".
"It would be unethical not to acknowledge that potential new treatments could both save lives and reduce transmission in this and future outbreaks," he told the Washington Post.
"We have more than 450 deaths [now it is over 600] so far, and not a single individual has been offered anything beyond tepid sponging and 'we'll bury you nicely'," Farrar told a separate Reuters interviewer. "It's just unacceptable."
Professor Farrar is not alone in questioning whether the West is doing enough to cure a virus that has, so far, only killed people in Africa.
"Farrar is one million per cent right," said Dr Peter Walsh, a biological anthropologist at the University of Cambridge, who has studied the spread of Ebola. "There's absolutely no ethical question involved here. The question is financial and political. To license the drugs that are currently being developed will take years and years. The problem is there is no commercial market in Africa. If this was Western Europe, or North America, we would have a vaccine," he told HuffPost UK.
"There's no monetary incentive for big pharma to put a lot of resources into it. Rest assured, it would have been done if this was happening in England or the US. We would be banging down doors to get to it and get it out to people."
Walsh pointed to the story of a German researcher who accidentally pricked herself with a needle containing Ebola, who was given a vaccine developed in the National Microbiology Laboratory in Winnipeg.
"She had it in her within 48 hours. We don't know, actually, if she ever did contract the disease in the first place but she never developed symptoms. But it shows how they were willing to try the vaccine, and could get it to her quickly," he said.
David Heymann, a professor at the London School of Hygiene and Tropical Medicine, who has studied Ebola since 1976, vehemently disagrees. "There are survivors of Ebola," he told Bloomberg. "Is it ethical to provide a drug when you could be causing a risk to those patients who would survive?
"It would be unethical to roll it out now, in my opinion," said Heymann, a former assistant director general at the WHO.
Dr Heinz Feldmann, an Ebola expert at the US National Institute of Allergy and Infectious Diseases' Laboratories in Montana, told the Canadian Press that he was being bombarded with emails asking why scientists were not pushing out any drug they could. But one colleague had persuaded him it would be a bad idea. "He said 'Anything injectable would be a disaster.'" Feldmann claimed. "He thinks the rumour that we're just spreading the disease is going to be out there before we even start. I think as bad as it sounds — and I really don't feel good about saying this — I have the feeling they have to find a way to end this one without [experimental] therapy."
Ebola is one of the world's deadliest diseases, with up to 90% of cases resulting in death. It is passed to humans through direct contact with the blood, organs or other bodily fluids of victims, meaning doctors and nurses are most at risk. Patients are often overcome by a sudden onset of fever as well as weakness, muscle pain and headaches. Vomiting, diarrhoea, rashes, kidney and liver problems follow. No vaccine or cure is currently available, but several are in development.
One of the US companies named in an informative Forbes piece on Ebola cures is BioCryst Pharmaceuticals, a small North Carolina operation, which is developing a drug called BCX4430 that has proven effective in preventing the death of monkeys were infected with a virus closely related to Ebola.
The tests took place with some funding from National Institute of Allergy and Infectious Diseases at a US Army Medical Research Institute, the report into the drug published in Nature, found. All six monkeys infected with the closely-related Marburg virus, which were given the drug one to 24 hours later, were alive 30 days later. All six monkeys who were not given the drug were dead.
"Much of the only real funding now, which is mainly coming from the US department of Defence, is for bio- terror research - it had been thought that it might be used as a biochemical weapon against Americans," Walsh said.
Dr William Sheridan, BioCryst's medical director, told NPR that testing such a drug "just wouldn't make the cut at a major [pharma] company," because the disease has not yet killed a huge number of people, objectively. But he said the company wanted to develop a drug because of the mounting public health concern, and because "there is a market, and the market is the US government."
Rob Bennett, BioCryst’s vice president of investor relations and operations, told Forbes he had had a lot of interest in the drug but it had never been tested on humans. “We don’t see a path to dose patients without at least some fundamental safety data. There would be some ethical issues around that, so it’s a catch-22,” he said.
Paul Hunter, professor of Health Protection at the University of East Anglia, disagrees that there is any ethical dilemma. "As a practicing clinician, if I was given the option to help people with a drug that isn't proven, but has been shown to have at least some effect, it's unethical not to give it to them," he told HuffPost UK.
"In the midst of such a huge epidemic, one could even argue that doing a blind controlled trial would be unethical, because if you give a placebo to some people, who will most likely die, then you are depriving them of a drug that could cure them, something that could save their life.
"It can take months, years for a drug to get approval. By the time it is licensed, maybe everybody will already be dead."
The Canadian Tekmira Pharmaceuticals is also developing a drug to treat Ebola, but the trials were placed on hold earlier this month by the Food and Drug Administration, which requested additional information to ensure the drug is safe at higher doses, according to a Bloomberg report. Additional animal trials are now being conducted until at least 2015.
Mapp Biopharmaceutical Inc, a San Diego company, is another company developing an antibody cocktail similar to the one tested by Canada's National Microbiology Laboratory, according to Bloomberg.
If most scientists agree that trialling even the most experimental drugs would not be unethical, why isn't it happening? Hunter claims it could be lack of supply: "There just aren't enough drugs that exist on the planet to start trying them out. It takes time to scale up what you are producing," he said.
"There also could be many issues around importing the drugs, African countries have been burned before, they've had pharma companies trying to offload totally unsuitable, banned drugs to developing nations."
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